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Scott, McCollum: Strange Bedfellows on Health Care

Bill McCollum's offensive against Rick Scott's well-publicized "mistakes" at Columbia/HCA is shining a light on McCollum's own health-care record in Congress.

Anyone who's been paying attention to the increasingly acrimonious Republican gubernatorial campaign knows by now that Scott was chairman and CEO of the HCA hospital chain when it was fined $1.7 billion by federal authorities.

After a decade at the helm, Scott resigned in 1997, and his TV ads openly admit that "mistakes were made." If Columbia/HCA tried to cover its financial tracks in the 1990s, its erstwhile CEO today is well aware that his record will be under microscopic scrutiny on the campaign trail.

McCollum's health-care record is less well-known, and it was eerily aligned with Scott's.

At the time Scott was taking fire at HCA, McCollum was promoting a softer approach to the problem of health-care fraud, and earning contributions from Scott's company.

In 1998, then-U.S. Rep. McCollum introduced the "Health Care Claims Guidance Act," which, according to some analyses, would make whistle-blower cases harder to file.

The Congressional Budget Office estimated that McCollum's bill -- which did not pass -- would cost taxpayers $6.3 billion over 10 years because it allowed for more Medicare and Medicaid overbilling from health care companies.

Sen. Charles Grassley, R-Iowa, said at the time that the "McCollum bill is not designed to stop the prosecution of innocent mistakes. Rather, it would make fraud easier to accomplish more often. And it would establish new 'look-the-other-way' loopholes, including for ongoing cases such as Columbia/HCA."

McCollum called Grassley's interpretation "hogwash," but subsequently he received a $3,000 campaign donation from Columbia/HCA executives, according to the Center for Responsive Politics.

From 1983-2001, McCollum's stint in Congress, the Congressional Record contains no mention of McCollum publicly criticizing Columbia/HCA.

What McCollum did say in introducing his legislation on March 19, 1998, was this:

"In our zeal to crack down on health-care fraud and abuse, we must be careful not to throw our nets so wide that we ensnare honest providers who are making inadvertent billing mistakes.''

Scott could have made a similar claim by noting that Columbia/HCA was hardly alone. Dozens of health-care providers paid millions in fines, including Yale Hospital, Duke University Hospital, Harvard University Hospitals, University of Chicago Hospitals, Johns Hopkins and HCA rival Tenet.

Skeptics speculate that the widening enforcement dragnet -- government investigations quadrupled from 1992-1998 -- was little more than revenge for the industry's role in defeating the Clinton administration's health care reform program. Much of what regulators classified as "fraud" were, arguably, billing errors precipitated by volumes of confusing or conflicting government rules.

Indeed, McCollum himself called the crackdown a "witch hunt" and declared while introducing his bill:

We should not carelessly paint all health-care billing mistakes as billing fraud. The most innocent of providers often feel forced to settle these claims instead of facing the prospect of an automatic $10,000 fine for a small disputed amount.

Considering that providers are faced with a federal health-care payment system of more than 1,700 pages of law and over 1,200 pages of regulations interpreting those laws, as well as thousands of additional pages of instruction, it is inevitable that human error will occur and that erroneous claims will be submitted.

"Even if a provider could clearly prove their innocence and show that these claims resulted from innocent clerical error, they would be likely to settle the case rather than incur large legal costs.

None of this is to suggest that HCA didn't make mistakes or to absolve a CEO who admits he wasn't paying enough attention to the accounting end of the business. Scott freely acknowledges that many errors were made.

But the record also shows that Scott left Columbia/HCA voluntarily and was never charged with wrongdoing.

Ultimately, the 11th Circuit Court of Appeals ruled that the Clinton administration's regulations were so convoluted that reasonable people could disagree on their application. The court dismissed cases filed against other employees.

``Bill McCollum's inconvenient truth is that he strenuously defended HCA against the Clinton witch hunt until he saw an opportunity to score cheap political points,'' Baker said. ``What a shock ... career politician Bill McCollum is a hypocrite.''

Since leaving Congress and winning election as Florida's attorney general, McCollum has become more assertive in combatting health care fraud. His office reports recovering more than $200 million in Medicare funds.

Ironically, McCollum and Scott now find themselves on the same page on health care -- just as they did more than a decade ago. Both men rabidly oppose President Barack Obama's health-care law.

Scott helped to launch the "Conservatives for Patient Rights" advocacy group, which follows on the industry campaign he organized against Hillary Clinton's health-care initiative in the '90s.

McCollum, meantime, is leading 20 state attorneys general in challenging the constitutionality of Obama's program.

Baker, Scott's spokeswoman, said that while Scott supports the lawsuit, "The attorney general should have been more proactive in fighting Obamacare.

"Rick Scott has said he will work to pass a law making it illegal to require Floridians to buy health insurance."

And whatever semblance of detente ends there.

The McCollum campaign built a Web site -- The Rick Scott Fraud Files -- that purports to detail Scott's misdealings in the health-care arena.

By primary day, every Florida voter will know the role Rick Scott played in defrauding taxpayers in the largest Medicare fraud scheme in American history," the site states.

Meanwhile, a new TV ad paid for by a group called the Florida First Initiative hammers Scott's tenure at Columbia/HCA.

The site includes a "Fact Check" feature that quotes a Florida newspaper debunking the attorney general's claim that Scott "barely escaped imprisonment."

Some conservatives flinch when McCollum's hit pieces echo the Democratic line of attack on Scott.

"What is aggravating to me is that McCollum is now attacking Scott based on what the Democrats did to punish him for opposing Hillarycare. I dont have a dog in the fight, but I really bristle when Republicans start attacking using the Center for American Progress as the starting ground," wrote Erick Erickson at RedState.com.

"McCollum wouldnt be having this problem (in the polls) at all if his campaign werent so lackluster with a sense of entitlement."